Is Afluria a Live Vaccine?
No, Afluria is NOT a live vaccine—it is a trivalent or quadrivalent inactivated influenza vaccine (IIV) containing killed virus. 1
Vaccine Classification
Afluria is classified as an inactivated influenza vaccine (IIV), which fundamentally differs from live attenuated influenza vaccine (LAIV) in several key ways 1:
- Type of virus: Afluria contains killed/inactivated virus, while LAIV (FluMist) contains live attenuated virus 1
- Route of administration: Afluria is given by intramuscular injection, while LAIV is administered as an intranasal spray 1
- Product composition: Afluria is an inactivated subvirion or surface antigen preparation, while LAIV is an attenuated, cold-adapted live virus 1
Clinical Implications for Patient Selection
Afluria can be safely used in immunocompromised patients because it contains inactivated virus and cannot cause influenza infection 2. This is a critical distinction from LAIV, which is contraindicated in immunocompromised individuals 2.
Key Safety Considerations:
- Immunocompromised patients: Afluria (IIV) is recommended; LAIV is contraindicated 2
- Pregnant women: Afluria (IIV) can be used; LAIV cannot 1
- Children with asthma or wheezing: Afluria (IIV) is appropriate; LAIV is contraindicated 1
- Healthcare workers: Either vaccine type can be used if otherwise eligible 1
Age-Specific Recommendations for Afluria
Afluria is approved for persons aged ≥9 years per ACIP recommendations, though the package insert indicates ≥5 years 1. The ACIP recommends against using Afluria in children aged 6 months through 8 years due to increased febrile reactions observed in this age group during the 2010 Southern Hemisphere season 1. However, by 2017, following manufacturing process changes using higher detergent concentration to reduce lipid content, this restriction was lifted and Afluria could be used in persons aged ≥5 years 1, 3.
Common Pitfall to Avoid:
Do not confuse Afluria (inactivated) with FluMist (live attenuated) when counseling patients about vaccine safety, particularly for immunocompromised individuals or pregnant women 1, 2. The distinction between killed and live virus is critical for appropriate patient selection and safety.